Use of malleoli as an indicator for flatfoot in patients with Down syndrome: development of a simple and non-invasive evaluation method through medial longitudinal arch.
Yoshihide Kanai, Hirotaka Mutsuzaki, Momoko Watanabe and 4 others
PMID 32425347WHAT IT FOUND
In 16 children with Down syndrome and flatfoot, ankle bone heights on radiographs tracked the arch bone height closely.
The inner ankle bone may be a simpler landmark for assessing flatfoot, but surface testing is still needed.
Key findings
01In 16 feet from children with Down syndrome and flatfoot, medial malleolus height correlated with talo-navicular joint height (r=0.86, p<0.001).
02Lateral malleolus height also correlated with talo-navicular joint height (r=0.88, p<0.001).
03The study did not measure these landmarks from the foot surface, so it does not yet show that palpating the malleoli can replace navicular assessment in clinic.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample was very small, with only 16 feet. The study was retrospective and used existing radiographs. The measurements were taken from radiographs, not from the foot surface. Knee alignment was not confirmed, and valgus knee may affect lateral malleolus height. No actual surface evaluation of the medial malleolus was performed. The paper describes itself as a preliminary study, not a validated clinical method.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not treat the medial malleolus as a validated surface test for flatfoot in Down syndrome. The study measured existing radiographs, not foot-surface landmarks, and included only 16 feet.